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Tea tribe women in Assam face multiple barriers to combating anaemia and accessing adequate maternal health care, according to a report by Nazdeek, a legal empowerment organization, released on July 23.

The report said that various government interventions meant to combat anaemia are insufficient and unsuccessful in reaching the women they are intended to serve.

“There are various health services mandated by law to combat anaemia and decrease maternal mortality, but they are not reaching women on the ground. Free nutritional supplements that are vital to women during pregnancy, and owed to them under a government scheme, are not being disbursed to any pregnant women across the whole state. The poor access to health and nutrition is further exacerbated by tea plantation workers’ poor wages and exploitative working conditions,” said human rights lawyer and co-founder at Nazdeek, Jayshree Satpute.

The report – A Matter of Life and Death: Surviving Childbirth on Assam’s Tea Plantations – sheds lights on the multiple gaps in the implementation of government health interventions meant to decrease anaemia and maternal mortality at tea plantations in Assam. These women face multiple layers of oppression and exploitation and are unable to realize their right to safe motherhood.

“Major gaps exist in securing ambulances for women during pregnancy. In some cases, the ambulance takes so long to reach a woman’s home, that she delivers the baby while she’s waiting,” said Mary Surin Tete, a member of the central body of the All Adivasi Women’s Association of Assam (AAWAA).

Key findings of the report show that there is poor and inaccurate understanding of anaemia and its causes among many health workers and government officials. Also, availability of free nutritional supplements at Anganwadi Centers is sporadic and insufficient due to major gaps in funding disbursement. The existing blood procurement system erects barriers to women’s health and negatively affects poorer patients.

“The system for accessing blood transfusions in Assam discriminates against low-income women who cannot always bring someone to provide replacement blood. There is an urgent need for more resources to be contributed to blood banks across the state and for a heavier investment in blood donation programs,” said Simran Sachdev, the author and lead researcher of the report.

“Inadequate maternal health care is literally killing women and children in tea plantations across the state,” Sachdev added.

The report provides recommendations for government officials on how to strengthen services aimed at reducing anaemia and maternal mortality, as Assam has the highest maternal mortality rate in all of India with 363 maternal deaths per 100,000 live births. Nazdeek also urged various departments in the Assam government to immediately act on these recommendations.

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